Detection of carbapenemases in Enterobacteriaceae: a challenge for diagnostic microbiological laboratories J. Hrabák, E. Chudáčkova, C.C. Papagiannitsis

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Detection of carbapenemases in Enterobacteriaceae: a challenge for diagnostic microbiological laboratories J. Hrabák, E. Chudáčkova, C.C. Papagiannitsis Clinical Microbiology and Infection Volume 20, Issue 9, Pages 839-853 (September 2014) DOI: 10.1111/1469-0691.12678 Copyright © 2013 European Society of Clinical Infectious Diseases Terms and Conditions

FIG. 1 Algorithm proposed by Miriagou et al. [78] for interpretation of results obtained with the KPB/MBL confirmation-based Method B. The algorithm has been modified for the detection of OXA-48-type carbapenemases and the use of screening cut-offs proposed by the European Committee on Antimicrobial Susceptibility Testing. *Ertapenem MIC ≥0.25 mg/L, imipenem MIC ≥2 mg/L or piperacillin–tazobactam (inhibition zone of <16 mm) can also be used. DPA, dipicolinic acid; MBL, metallo-β-lactamase; PBA, phenylboronic acid. Clinical Microbiology and Infection 2014 20, 839-853DOI: (10.1111/1469-0691.12678) Copyright © 2013 European Society of Clinical Infectious Diseases Terms and Conditions

FIG. 2 Proposed workflow for the detection of carbapenemases in diagnostic laboratories. MALDI-TOF MS, matrix-assisted laser desorption ionization time-of-flight mass spectrometry; MLST, multilocus sequence typing; PFGE, pulsed-field gel electrophoresis. Clinical Microbiology and Infection 2014 20, 839-853DOI: (10.1111/1469-0691.12678) Copyright © 2013 European Society of Clinical Infectious Diseases Terms and Conditions